An Effort Index for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)

Silverberg, Noah D.; Wertheimer, Jeffrey; Fichtenberg, Norman L.

doi:10.1080/13854040600850958

Cited by 119 publications

(96 citation statements)

References 50 publications

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“…Participants were retrospectively excluded from the study if the results of the RBANS were indicative of insufficient effort. The RBANS Effort Index was calculated for each individual, and a cutoff score of more than 3 was adopted (Silverberg, Wertheimer, & Fichtenberg, 2007). Subsequently, 41 participants (13.6% of the total sample) were excluded, leaving a final sample of 260 participants.…”

Section: Methods Participantsmentioning

confidence: 99%

The Relationship Between Self-Reported Neuropsychological Risk Factors and RBANS Test Performance Among Forensically Committed Psychiatric Inpatients

Bailie

King

Kinney

et al. 2012

Applied Neuropsychology: Adult

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Patients who are committed to a psychiatric inpatient hospital are at increased risk for neuropsychological compromise. This study investigated a large (n = 260) and diverse sample of patients at a forensic state psychiatric hospital. A substantial proportion (35.8%) of the sample performed two standard deviations below the normative mean on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). In addition, 65% of the participants reported a history of developmental delays, less than 12 years of education, or past learning difficulties. Participants who reported these developmental and academic problems performed worse on the RBANS compared with those without such a history. Additionally, the more developmental/educational risk factors a participant reported, the more likely they were to be impaired on the RBANS. Half of the sample reported a history of at least one neurological risk factor (e.g., history of head injury with loss of consciousness). However, in this sample, a history of neurological risk factors did not influence overall performance on the RBANS and did not increase the likelihood of impairment. These results speak to the relevance of neuropsychological services at state psychiatric hospitals and provide some evidence that a history of developmental or academic problems may help identify psychiatric patients with neuropsychological compromise.

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Section: Methods Participantsmentioning

confidence: 99%

The Relationship Between Self-Reported Neuropsychological Risk Factors and RBANS Test Performance Among Forensically Committed Psychiatric Inpatients

Bailie

King

Kinney

et al. 2012

Applied Neuropsychology: Adult

View full text Add to dashboard Cite

show abstract

“…Although several embedded measures have been derived from the TMT, Merten and colleagues used the Trail-Making Test-B (TMT-B): Trail-Making Test-A (TMT-A) Ratio (Iverson et al, 2002;Ruffolo, Guilmette, & Willis, 2000) in a sample of participants with Alzheimer's disease and found that it showed promising specificity (95%) for use in dementia samples. Another embedded measure that has been investigated for its efficacy in an elderly population is the Effort Index from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS EI; Silverberg, Wertheimer, & Fichtenberg, 2007). Barker, Horner, and Bachman (2010) found sensitivity levels of 42% in a geriatric sample, which included approximately 23% dementia diagnoses.…”

Section: Bortnik Horner and Bachmanmentioning

confidence: 99%

“…The purpose of the current study was to examine the clinical utility of several effort measures in a sample of patients with dementia diagnoses. The EI from the RBANS (Silverberg et al, 2007), TMT Ratio (Reitan, 1958), RFIT (Rey, 1964) with recognition trial , and the TOMM (Tombaugh, 1996(Tombaugh, , 1997 were evaluated.…”

Section: Bortnik Horner and Bachmanmentioning

confidence: 99%

Performance on Standard Indexes of Effort Among Patients with Dementia

Bortnik

Horner

Bachman

2013

Applied Neuropsychology: Adult

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Assessment of response validity is an integral part of neuropsychological practice. Although many studies have demonstrated the efficacy of stand alone and embedded effort measures in a variety of medical and compensation-seeking contexts, much less is known about the robustness of these measures in elderly populations, particularly in patients with dementia. Although older adults may be viewed as less likely to intentionally feign symptoms for an external gain, there are a variety of other factors that could result in suboptimal effort, including fatigue, lack of interest or cooperation in the testing process, or failure to fully appreciate the implications of the assessment on treatment care and outcome. The current study examined the clinical utility of several stand alone and embedded effort measures including the Repeatable Battery for the Assessment of Neuropsychological Status Effort Index, Trail-Making Test Ratio, Rey 15-Item Test, and the Test of Memory Malingering in a sample of patients with dementia. Results found that the majority of effort indexes demonstrated unacceptably high false-positive error rates with specificity levels as high as 83%. These findings demonstrate the need for caution in interpreting effort measure performance in dementia samples due to the fact that despite their best effort, many patients with dementia fail effort measures and are at risk for being misclassified.

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“…The RBANS has been validated to assess cognitive functioning among a variety of populations, including TBI [45]. An Effort Index (RBANS EI) was calculated for the RBANS based on the work of Silverberg et al [46] using digit span and memory recognition raw scores. Individuals with an RBANS EI greater than zero (i.e., list recognition <18 or digit span <8) were classified as invalid.…”

Section: Cognitive Functioningmentioning

confidence: 99%

Factors associated with neurocognitive performance in OIF/OEF servicemembers with postconcussive complaints in postdeployment clinical settings

et al. 2014

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Abstract-Cognitive difficulties are frequently reported byOperation Iraqi Freedom/Operation Enduring Freedom military personnel who sustained mild traumatic brain injuries (TBIs). The current study examined several potential factors that may contribute to self-reported cognitive difficulties in postdeployment clinical settings. Eighty-four subjects who sustained a mild or moderate TBI and reported cognitive difficulties underwent neurocognitive testing. Multiple regression analyses were used to determine the amount of variance in neurocognitive performance accounted for by the predictor variables (demographic, mechanism of injury, time since injury, headache severity, combat stress, postconcussive complaints, and effort/performance validity). The predictor variables collectively accounted for 51.7% of the variance in cognitive performance (F (8,72) = 11/99, p < 0.001). The most potent predictor of cognitive functioning was performance validity/ effort, which uniquely accounted for 16.3% of the variance (p < 0.01). Self-reported symptom severity, including postconcussive complaints, combat stress, and headache intensity, accounted for 7.2% of the variance (p < 0.05). Demographic factors and injury characteristics, such as time since injury and mechanism of injury, were not significant predictive factors of cognitive performance. The findings of the current study underscore the need to include measurement of effort as part of neurocognitive evaluation in postdeployment settings when evaluating cognitive complaints associated with mild TBI.

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An Effort Index for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)

Cited by 119 publications

References 50 publications

The Relationship Between Self-Reported Neuropsychological Risk Factors and RBANS Test Performance Among Forensically Committed Psychiatric Inpatients

The Relationship Between Self-Reported Neuropsychological Risk Factors and RBANS Test Performance Among Forensically Committed Psychiatric Inpatients

Performance on Standard Indexes of Effort Among Patients with Dementia

Factors associated with neurocognitive performance in OIF/OEF servicemembers with postconcussive complaints in postdeployment clinical settings

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